Evaluation and Assessment Overview.pptx
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Evaluation and Assessment Overview FIRST AID – HEAD INJURIES/CONCUSSIONS • Physical symptoms – Blacking out, even if briefly – Seeing “stars” or lights in front of the eyes – Blurred or double vision – Nausea or vomiting – Headaches – Light sensitivity – Lack of motor coordination or difficulty ba...
Evaluation and Assessment Overview FIRST AID – HEAD INJURIES/CONCUSSIONS • Physical symptoms – Blacking out, even if briefly – Seeing “stars” or lights in front of the eyes – Blurred or double vision – Nausea or vomiting – Headaches – Light sensitivity – Lack of motor coordination or difficulty balancing – Tinnitus – Uneven pupil sizes – Unusually large pupils – Bleeding at the scalp • Cognitive symptoms – Feeling or appearing dazed – Memory problems – Disorientation and confusion – Trouble focusing – Post-traumatic amnesia – Slurred or incoherent speech – Mood changes – Restlessness – Lethargy – Irritability FIRST AID – HEAD INJURIES/CONCUSSIONS * • What to do: – Call 911 – Immobilize the head – Apply ice to reduce swelling – Keep checking cognitive abilities – For the first 24 hours after a concussion the person should not be alone. Let them sleep, but wake them up once every 15 minutes for the first two hours, then once every 30 minutes for the next two hours; then once an hour. Battle Roster # ● Write first letter of casualty’s first name, then first letter of casualty’s last name, and then write the last four numbers of casualty’s social security number ○ For example, John Doe 123-12-1234 is Battle Roster # ‘JD1234’ EVAC ● ● ● Urgent: within 30 minutes Priority: within 24 hours Routine: within 72 hours (or when available) Name ● Last, First Full name Last 4 ● Last 4 of SSN Gender ● Mark an ‘X’ on casualty’s gender (Male (M) or Female (F)) Date ● Write date of injury in DD-MMM-YY format. For example, “29-Jun-13 Time ● Write 24 hour time of injury and indicate whether local (L) or zulu (Z) time. For example, 1300L Service ● Write casualty’s branch of service (USA, USAF, USCG, USN, USMC). For US civiliams, write US CIV. For non-US personnel, write “NON US” or a standard abbreviation for casualty’s nationality. Unit ● Write casualty’s unit name. For example, 7231st Medical Readiness Unit Allergies ● Write casualty’s known drug allergies. If no drug allergies, write “NKDA” (no known drug allergies) Mechanism of Injury ● Mark an ‘X’ on the mechanism or cause of injury (artillery, blunt, burn, fall, grenade, gunshot wound (GSW), improvised explosive device (IED), landmine, motor vehicle crash/collision (MVC), rocket-propelled grenade (RPG), other (specify). Mark all that apply Injury ● Mark an “X” at the site of the injury(ies) on the body picture. For burn injuries, circle the burn percentage(s) on the figure. If multiple mechanisms of injury and multiple injuries, draw a line between the mechanism of injury and the anatomical site of the injury. TQ: R Arm ● If a tourniquet is applied to the right arm, write type of tourniquet used and the time of tourniquet application TQ: L Arm ● If a tourniquet is applied to the left arm, write type of tourniquet used and the time of tourniquet application TQ: R Leg ● If a tourniquet is applied to the right leg, write type of tourniquet used and the time of tourniquet application TQ: L Leg ● If a tourniquet is applied to the left leg, write type of tourniquet used and the time of tourniquet application Time, Pulse (rate & location), Blood Pressure, Respiratory Rate, Pulse Ox %, O2 Sat, AVPU, Pain Scale (0-10) ● Record vital signs (pulse rate and location, blood pressure, respiratory rate, oxygen saturation), level of consciousness (AVPU: Alert, responds to Verbal stimuli,responds to Pain stimulus, Unresponsive), and level of pain (on numeric rating scale of 0 to 10, with 0 being no pain and 10 being the worst pain) with time. Battle Roster # ● Write first letter of casualty’s first name, then first letter of casualty’s last name, and then write the last four numbers of casualty’s social security number ○ For example, John Doe 123-12-1234 is Battle Roster # ‘JD1234’ Evacuation (EVAC) ● Mark an “X” on the casualty’s evacuation priority/precedence ○ (Urgent, Priority, Routine) C ● Mark an “X” for all Circulation hemorrhage control intervention. For tourniquets (TQ), mark category (Extremity, Junctional and/or Truncal) and write name of TQ(s) used. For dressings, mark category (Hemostatic, Pressure, and/or Other) and write type of dressing(s) used. A ● Mark an “X” for all Airway interventions (Intact, NPA (nasopharyngeal airway), CRIC (cricothyroidotomy), ET Tube (endotracheal tube), SGA (supraglottic airway) and write type of device(s) used. B ● Mark an “X” for all Breathing interventions (O2(oxygen), Needle-D (needle decompression), Chest-Tube, Chest Seal) and write type of device(s) used. C: Fluid ● Circulation resuscitation interventions. Write name, volume, route and time of any fluids given. C: Blood Product ● Circulation resuscitation interventions. Write name, volume, route and time of any blood products given. Meds: Analgesic ● Medications. Write name, dose, route, and time of any analgesic given. Meds: Antibiotic ● Medications. Write name, dose, route, and time of any antibiotics given. Meds: Other ● Medications. Write name, dose, route, and time of any other administered medications. Other ● Mark an “X” for other treatments administered (combat pill pack, eye shield (mark right (R) or left (L)), splint, hypothermia prevention and type of device(s) used. Notes ● Use this space to record any other pertinent information and/or clarifications. First Responder Name ● Print the first responder’s name (Last, First) First Responder Last 4 ● Write last four numbers of first responder’s Social Security number Conducting Head-to-Toe Assessments Conducting assessments and providing rapid treatment are the first steps CERT volunteers take when working with a patient. During an assessment, you should look for: ● ● ● Severe bleeding Low body temperature Airway obstruction Conducting Head-to-Toe Assessments ● ● A head-to-toe assessment goes beyond the immediate life-threatening injuries to try to determine the nature of the patient’s injury. Perform the entire assessment before initiating treatment. Do not conduct an assessment if a patient requires immediate care to prevent serious injury or death. In these cases, CERT volunteers should administer the necessary treatment before they follow up with an assessment. Objectives of Head-to-Toe Assessments The objective of a head-to-toe assessment are to: ● ● ● Determine, as clearly as possible, the extent of the injuries Determine what type of treatment the patient needs; and Document injuries Remember to wear your PPE when conducting head-to-toe assessments What to Look for in Head-to-Toe Assessments The medical community uses the acronym DCAP-BTLS to remember what to look for when conducting a rapid assessment. DBAP-BTLS stands for the following: ● ● ● ● ● ● ● ● Deformities Contusions (bruising) Abrasions Punctures Burns Tenderness Lacerations Swelling What to Look for in Head-to-Toe Assessments ● ● ● When conducting a head-to-toe assessment, CERT volunteers should look for DCAP-BTLS in all parts of the body Remember to provide IMMEDIATE treatment for life-threatening injuries Pay careful attention to how people have been hurt (what caused the harm) because it provides insight to probable injuries suffered How to Conduct a head-to-Toe Assessment ● ● Whenever possible, CERT volunteers should ask the person about any injuries, pain, bleeding, or other symptoms. If the patient is conscious, CERT members should always ask permission to conduct the assessment. The patient has the right to refuse treatment Be sure to talk with the conscious patient to reduce anxiety Head-to-Toe Assessments Should Be: ● ● ● Conducted on all survivors, even those who seem all right Verbal (if the patient is able to speak) Hands on. Do not be afraid to remove clothing to look. Make sure you conduct each head-to-toe assessment the same way; doing so will make the procedure quicker and more accurate with each assessment. Remember to: ● ● ● ● Pay careful attention Look, listen and feel for anything unusual Suspect a spinal injury in all unconscious survivors and treat accordingly Check your own hands for patient bleeding as you perform head-to-toe assessment While conducting a head-to-toe assessment, CERT volunteers should always check for: ● ● Pulse, movement, sensation (PMS) in all extremities Medical ID emblems on bracelet or necklace Closed-Head, Neck and Spinal Injuries ● ● ● When conducting head-to-toe assessments, rescuers may find survivors who have or may have suffered closed-head, neck, or spinal injuries A closed-head injury is a concussion-type injury as opposed to a laceration, or tear wound, although lacerations can indicate that the survivor has suffered a closed-head injury The main objective when CET members encounter suspected injuries to the head or spine is to do no harm. You should minimize movement of the head and spine while treating any life-threatening conditions The signs of a closed-head, neck, or spinal injury most often include: ● ● ● ● ● ● ● ● ● ● ● ● Change in consciousness Inability to move one or more body parts Severe pain or pressure in head, neck, or back Tingling or numbness in extremities Difficulty breathing or seeing Heavy bleeding, bruising, or deformity of the head or spine Blood or fluid in the ears or nose Bruising behind the ear “Raccoon” eyes (bruising around eyes) “Uneven “ pupils Seizures Nausea or Vomiting Closed-Head, Neck and Spinal Injuries ● If survivors are exhibiting any of these signs or if the survivor is found under collapsed building material or heavy debris, you should treat them as having a closed-head, neck, or spinal injury Stabilizing the Head ● During a disaster, ideal equipment is rarely available. CERT members may need to be creative by: ○ ○ ● Looking for materials - a door, desktop, building materials - to use as a backboard Looking for items - towels, draperies, or clothing - to stabilize the head on the board by tucking them snugly on either side of the head to immobilize it Only move survivors to increase the safety of the rescuer and survivor or when professional help will be delayed, and a medical treatment area is established to care for multiple survivors Closed-Head, Neck and Spinal Injuries ● Moving patients with suspected head, neck, or spinal injury requires sufficient patient stabilization. However, if the rescuer or patient is in immediate danger, move the patient from the area as quickly as possible
